Gliederung

Background: One possibility for the surgical treatment of disabling shoulder arthropathy where anatomical total shoulder arthroplasty is limited is Reverse Total Shoulder Arthroplasty. First evaluation in our own patients so as in the whole literature by short and midterm results of arthroplasty with the use of reverse prosthesis confirmed new, unusual complications, not known by previous conventional shoulder arthroplasty as the notching problem. Clinical outcome is analyzed evaluating short term results with the new type of glenosphere avoiding notching problems.

Methods: 117 patients (2005 & 2006) undergoing surgery were investigated retrospectively (Clinical Exam, X-ray, Shoulder Score); we report the result after Reverse Shoulder Arthroplasty with the 36mm concentric glenosphere in comparison with the 36mm eccentric and the 44mm glenosphere in short term outcome (average follow-up 14 months).

Results: From the 36mm concentric group, 36% showed in the follow-up radiological changings with bony erosion on the scapular neck, corresponding to inferior scapula notching. Compared with the 36mm eccentric and the 44mm glenosphere group (no radiological findings of bony erosion on the scapula)in patients with equal diagnosis they produced lower results in the outcome findings.

Conclusions: We attribute better clinical outcome in the first short term results after Reverse Shoulder Arthroplasty to the lowering of the centre of rotation preserving the good bone stock in the middle of the glenoid for fixation of the glenoid component, evitating inferior notching by the 36mm eccentric glenosphere and the enlargement of the glenosphere 44mm. Major mobility, joint stability and patientÂ´s satisfaction is documentated.